The integration of palliative care into the continuum of care for all patients with cancer is recognized as essential for optimal oncology care, but trainin in this area is inadequate. Each year in the U.S., 30%-50% of the 1.5 million people diagnosed with cancer and 70%-90% of the 500,000 people with end-stage cancer experience unrelieved suffering. This occurs despite research demonstrating that the majority of suffering associated with cancer can be relieved by oncologists with adequate palliative care training. This persistent suffering is a result of the failure to translate palliative care knowledge to the practices of US oncologists. For the last ten years, we have been developing effective curricular elements for teaching palliative care. In this project, we will build on that track record. We have the commitment of the American Society of Clinical Oncology (ASCO) and its Oncology Training Programs Subcommittee of the Professional Development Committee that represents program directors to develop, evaluate, and disseminate a novel, online curriculum that will improve the training of all oncology fellows in perpetuity. This project has the potential for enormous impact on cancer patients. With the commitment and support of ASCO, its strong education programs and excellent online education platform, and the expertise and experience of the investigators, this proposal has the potential to improve the care of all oncology patients through the advancement and standardization of how palliative care is taught to oncology fellows. The specific aims of this project are: 1. Develop an online interactive curriculum in palliative medicine for oncology fellows accessible through the prominent and successful ASCO University educational website; 2. Test the hypothesis that an online interactive curriculum yields changes in knowledge, skills, and behavior to the same extent as exposure to the online curriculum in addition to participation in a clinical rotation in palliative care; 3. Test the hypothesis that fellows who complete an online interactive curriculum will perform better on the oncology in-training examination than fellows who do not complete such a curriculum; and 4. Test the hypothesis that fellows who complete an online interactive curriculum will change their prescribing behavior. PUBLIC HEALTH RELEVANCE: Research shows that the majority of suffering experienced by cancer patients can be relieved by oncologists who have adequate training in the evaluation and treatment of symptoms. This project will develop an innovative curriculum to teach these skills to oncologists who are in training. We will judge the effectiveness of the training by evaluating change in physicians' knowledge and by tracking changes in their medication prescribing habits.